Physical examination maneuver

Physical Exam

Chest and Respiratory Inspection

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Video coming September 2026

How to Perform

With the patient undressed to the waist and breathing quietly, observe the rate, depth, rhythm, and effort of breathing and the symmetry of chest-wall movement. Note the chest shape, use of accessory muscles, intercostal or supraclavicular retractions, paradoxical movement, and any cyanosis or pursed-lip breathing.

How to Interpret

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References

  • Holleman DR Jr, Simel DL. Does the clinical examination predict airflow limitation? JAMA. 1995 Jan 25;273(4):313-319. doi:10.1001/jama.1995.03520280059039. PMID: 7815660. [Named source (JAMA Rational Clinical Examination): independent bedside predictors of airflow obstruction are wheezing, forced expiratory time, peak flow, and smoking; accessory muscle use and pursed-lip breathing are associated but NOT independent predictors and have no reported isolated sensitivity or specificity.]
  • Bickley LS, Szilagyi PG, Hoffman RM, Soriano RP. Bates' Guide to Physical Examination and History Taking. 13th ed. Philadelphia, PA: Wolters Kluwer; 2021.
  • Swartz MH. Textbook of Physical Diagnosis: History and Examination. 9th ed. Philadelphia, PA: Elsevier; 2025.

Related Systems / Regions

RespiratoryThorax

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